Cognitive impairment is a well‐recognized and debilitating symptom of Parkinson's disease (PD). Degradation in the cortical cholinergic system is thought to be a key contributor. Both postmortem and in vivo cholinergic positron emission tomography (PET) studies have provided valuable evidence of cholinergic system changes in PD, which are pronounced in PD dementia (PDD). A growing body of literature has employed magnetic resonance imaging (MRI), a noninvasive, more cost‐effective alternative to PET, to examine cholinergic system structural changes in PD. This review provides a comprehensive discussion of the methodologies and findings of studies that have focused on the relationship between cholinergic basal forebrain (cBF) integrity, based on T1‐ and diffusion‐weighted MRI, and cognitive function in PD. Nucleus basalis of Meynert (Ch4) volume has been consistently reduced in cognitively impaired PD samples and has shown potential utility as a prognostic indicator for future cognitive decline. However, the extent of structural changes in Ch4, especially in early stages of cognitive decline in PD, remains unclear. In addition, evidence for structural change in anterior cBF regions in PD has not been well established. This review underscores the importance of continued cross‐sectional and longitudinal research to elucidate the role of cholinergic dysfunction in the cognitive manifestations of PD. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

中文翻译：

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帕金森病的胆碱能基底前脑完整性和认知：磁共振成像证据的重新评估


认知障碍是帕金森病 (PD) 的一种众所周知的令人衰弱的症状。皮质胆碱能系统的退化被认为是一个关键因素。尸检和体内胆碱能正电子发射断层扫描 (PET) 研究都提供了 PD 胆碱能系统变化的宝贵证据，这种变化在 PD 痴呆 (PDD) 中尤为明显。越来越多的文献采用磁共振成像 (MRI)（一种非侵入性且更具成本效益的 PET 替代方案）来检查 PD 中的胆碱能系统结构变化。本综述对基于 T1 和弥散加权 MRI 的胆碱能基底前脑 (cBF) 完整性与 PD 认知功能之间关系的研究方法和结果进行了全面讨论。在认知受损的 PD 样本中，Meynert 基底核 (Ch4) 体积持续减少，并显示出作为未来认知能力下降的预后指标的潜在实用性。然而，Ch4 结构变化的程度，特别是在帕金森病认知能力下降的早期阶段，仍不清楚。此外，PD 前 cBF 区域结构变化的证据尚未确定。本综述强调了持续进行横断面和纵向研究以阐明胆碱能功能障碍在帕金森病认知表现中的作用的重要性。 © 2024 作者。 《运动障碍》由 Wiley periodicals LLC 代表国际帕金森和运动障碍协会出版。